Received: 15 August 2017
Accepted: 18 December 2017
Confirmatory molecular method for HTLV-1/2 infection
in high-risk pregnant women
Luine R.R. Vidal
Renate Von Linsingen
Aline N. Ferin
Talita Bessani Strapasson
Sergio M. de Almeida
Sonia M. Raboni
Newton S. Carvalho
Meri Bordignon Nogueira
Virology Section, Clinical Analyses
Laboratory, Clinical Hospital, Universidade
Federal do Paraná, Paraná, Brazil
Post Graduate Program in Gynecology and
Obstetrics, Universidade Federal do Paraná,
Pos doctorate of the Post Graduate Program
in Gynecology and Obstetric, Universidade
Federal do Paraná, Paraná, Brazil
Scientific Iniciation Program, Department of
Clinical Analysis, Universidade Federal do
Paraná, Paraná, Brazil
Instituto de Pesquisa Pelé Pequeno Príncipe,
Department of Gynecology and Obstetrics
Universidade Federal do Paraná, Curitiba, PR,
Luine R. R. Vidal, Virology Section, Clinical
Analyses Laboratory, Clinical Hospital,
Universidade Federal do Paraná, Brazil Rua,
Padre Camargo, 280, Bairro Alto da Glória,
Curitiba − Paran CEP: 80.060-240, Brazil.
Human T-cell lymphotropic virus types 1/2 (HTLV-1/2) are transmitted through sexual
intercourse, transfusion of blood components, and vertical transmission, predominantly
through breastfeeding. Six hundred forty-three pregnant women from a high-risk
prenatal care unit at a general hospital were tested by serological tests using
chemiluminescence (CMIA) for screening, followed by a molecular confirmatory test.
Four patients (0.6%) tested positive for HTLV-1/2 by CMIA, two samples (0.3%) for each
patient were confirmed as having HTLV-1 or HTLV-2 by PCR. The results show the
importance of inclusion of HTLV-1/2 screening for pregnant women in high-risk
prenatal care and the need for a molecular biological method to confirm HTLV-1/2
HTLV, molecular diagnosis, pregnancy, prenatal care
Human T-lymphotropic virus-1 (HTLV-1) is an oncogenic human
retrovirus that causes adult T-cell leukemia/lymphoma (ATLL) and
progressive HTLV-1-associated myelopathy/tropical spastic parapa-
HTLV-2, which is known to be endemic in African
Pygmies and Native Americans as well as common in drug users, has
not been clearly linked to any diseases.
Worldwide, it is estimated that about 15 to 20 million people are
infected with HTLV. The prevalence varies according to the geographic
area, socio-demographics and ethnic composition of the population, as
well as specific risk groups, such as injecting drug users, sex workers, and
people living with HIV (PLWH).
In Brazil, it is estimated that 2.5 million
people are infected with HTLV, with a frequency that varies according to
geographic localization, but Brazil is undoubtedly considered an endemic
The virus is transmitted from human to human through infected
lymphocytes and may be acquired through sexual intercourse, blood
transfusions, organ transplantations, contaminated needle reuse, and
from mother-to-child transmission (MTCT) during pregnancy, at birth,
and, more commonly, through breastfeeding.
The studies evaluating the frequency of HTLV-1 infection among
pregnant women in Brazil have shown prevalence levels varying from
0.08% to 1.30%.
However, investigation of HTLV during prenatal care is
scarce, and little is known about HTLV-1/2 prevalence in pregnant
women. The Brazilian Health Ministryhas recommended the investigation
of HTLV in the prenatal period, though only some Brazilian cities have
HTLV-1/2 tests included in prenatal care programs.
In Paraná state,
considered a non-endemic area, there are few studies specifically carried
out in native Indians, blood donors, and pregnant women, mainly in others
median size cities.
The objective of this study was to estimate the
© 2017 Wiley Periodicals, Inc. wileyonlinelibrary.com/journal/jmv J Med Virol. 2018;90:998–1001.